Pediatric Injury Prevention Health Communications Study

意外伤害是美国儿童死亡的主要原因，也是儿童发病率的主要原因。大多数伤害发病率和死亡率发生在家里或汽车里，通过使用预防性安全措施可以减少伤害发病率和死亡率。这项研究评估了初级保健环境中提供的量身定做的伤害预防信息的有效性和实用性。初步研究证明了在初级保健环境中提供伤害预防教育的计算机定制信息方法的潜在可行性和有效性。随后的研究测试了同时提供量身定制的父母和医生信息对健康儿童访视期间关于伤害预防行为的医生与父母沟通的影响，以及随后父母采用新的安全做法。在健康儿童探视期间，4岁及以下儿童的父母完成了一项计算机评估，并被随机分配以接受一般伤害预防信息、定制伤害预防信息或定制信息，并辅以针对提供者的定制摘要。在诊所就诊后一个月进行的跟踪评估表明，单独接受定制信息或提供方补充信息的父母比接受一般信息的父母更有可能报告采取新的伤害预防行为，并且这些影响在受教育程度最低的父母中最大。目前的研究致力于吸收和利用这一为儿童探视而设计的个人定制的伤害预防计算机程序，以加强提供关于安全行为的预期指导。北卡罗来纳州五家儿科诊所的样本实施了安全N声音伤害预防计划。跟踪计划使用率，进行评估计划使用情况的临床观察，由卫生保健提供者完成调查和焦点小组，并在计划实施之前和之后评估伤害预防预期指导的文档。这项研究将进一步为在初级保健环境中采用定制通信预防儿科伤害的战略的潜在开发和使用提供信息。

Unintentional injuries are the leading cause of death among U.S. children and a major cause of childhood morbidity. Most injury morbidity and mortality occur in the home or automobile, and may be decreased through the use of preventive safety practices. This research assesses the effectiveness and utility of tailored injury prevention information provided in the primary care setting. Initial research demonstrated the potential feasibility and effectiveness of a computer-tailored information approach to the provision of injury prevention education in the primary care setting. Subsequent research tested the impact of the delivery of concurrent tailored parent and physician information on physician-parent communication during the well-child visit regarding injury prevention behaviors and subsequent parent adoption of new safety practices. During well-child visits, parents of children ages 4 and younger completed a computer assessment and were randomized to receive generic injury prevention information, tailored injury prevention information, or tailored information supplemented with a tailored summary for providers. Follow-up assessment conducted one month following the clinic visit indicated that parents receiving tailored information alone or with supplementary provider information were more likely to report adopting a new injury prevention behavior than those receiving generic information, and these effects were greatest among the least educated parents. Current research addressed the uptake and utility of this individually-tailored injury prevention computer program designed for use during well child visits to enhance the provision of anticipatory guidance regarding safety behaviors. A sample of five pediatric clinics in North Carolina implemented the Safe N Sound injury prevention program. Rates of program usage were tracked, clinic observations assessing program usage were conducted, surveys and focus groups were completed by health care providers, and documentation of injury prevention anticipatory guidance were assessed prior to and following program implementation. This research will further inform the potential development and use of strategies employing tailored communications for pediatric injury prevention in the primary care setting.